Mothering Twins: First Year Insights
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Questions and Answers

What was the basic social psychological problem of mothering twins during the first year of life?

Life on hold

Which of the following are the phases mothers of twins progressed through to resume their lives? (Select all that apply)

  • Striving to reset (correct)
  • Pausing own life (correct)
  • Draining power (correct)
  • Resuming own life (correct)

What are the three conditions associated with the draining power phase?

Unrelenting demands, vanishing time, torn between two

What did mothers often describe the first 3 months of caring for twins as?

<p>The blur period (D)</p> Signup and view all the answers

What is a critical strategy used by mothers of twins to survive the first year?

<p>Establishing a routine</p> Signup and view all the answers

Mothers of twins often had more time for themselves than mothers with single infants.

<p>False (B)</p> Signup and view all the answers

Mothers needed to shift priorities to make the care of the twins number one, often leading to the _______ of house cleaning.

<p>lowering</p> Signup and view all the answers

What milestone often marked the beginning of mothers feeling more manageable after the birth of twins?

<p>When the twins slept through the night</p> Signup and view all the answers

What are two consequences mothers experienced as they began to resume their lives?

<p>Reaping the blessings (A), Becoming manageable (B)</p> Signup and view all the answers

What is the basic social psychological problem mothers of twins experience during the first year of their twins' lives?

<p>Life on hold</p> Signup and view all the answers

What are the four stages mothers of twins progress through to resume their own lives?

<p>Striving to reset (A), Resuming own life (B), Pausing own life (C), Draining power (D)</p> Signup and view all the answers

What percentage of mothers experienced inadequate sleep while raising twins, according to a study in Taiwan?

<p>49% (D)</p> Signup and view all the answers

What method was used to conduct this qualitative research?

<p>Grounded theory (B)</p> Signup and view all the answers

The primary support for this research was obtained from the University of Connecticut Research Foundation.

<p>True (A)</p> Signup and view all the answers

What did Holditch-Davis and Roberts (1999) report about mothers of multiples?

<p>They felt guilt about their infants waiting for food. (C)</p> Signup and view all the answers

During what time frame is the most vulnerable period for mothers of twins?

<p>The first 3 months postpartum</p> Signup and view all the answers

What is one major source of stress for parents of twins identified in the studies?

<p>Fatigue/lack of sleep</p> Signup and view all the answers

Mothers of twins commonly expressed concern over lack of time.

<p>True (A)</p> Signup and view all the answers

What was the mean age of the mothers interviewed in the study?

<p>32 (A)</p> Signup and view all the answers

What is 'maternal justice' as described by Anderson and Anderson (1990)?

<p>The need to give each twin fair and equal attention.</p> Signup and view all the answers

What is the term used to describe the need for mothers to treat twins equally?

<p>Maternal justice</p> Signup and view all the answers

What was identified as a source of stress for parents of twins by Williams and Medalie (1994)?

<p>Loss of control over mobility. (D)</p> Signup and view all the answers

Which research model focuses on social interactions among individuals?

<p>Symbolic interactionism (A)</p> Signup and view all the answers

The cornerstone of survival with twins during the first year of life is establishing a ______.

<p>routine</p> Signup and view all the answers

The percentage of mothers of multiples experiencing postpartum depression is lower than that of singletons.

<p>False (B)</p> Signup and view all the answers

What coping method was most often used by mothers in Kaplan’s (1998) study?

<p>Planful problem solving</p> Signup and view all the answers

What do mothers of multiples need most according to Chang (1990)?

<p>A sympathetic ear. (A)</p> Signup and view all the answers

Match the following authors with their key findings on parenting multiples:

<p>Holditch-Davis &amp; Roberts = Mothers feel guilty and tied down Williams &amp; Medalie = Loss of control over time Kaplan = Planful problem solving as a coping method Chang = Need for understanding support</p> Signup and view all the answers

What is the main focus of the ethnonursing study discussed?

<p>Cultural experiences, patterns, and practices of American Indian women with polycystic ovary syndrome (PCOS).</p> Signup and view all the answers

What are the three universal themes identified in the study?

<p>Control of PCOS symptoms for cultural well-being (A), Tribal culture and variations in practices (B), Importance of culturally congruent PCOS education and health care (C)</p> Signup and view all the answers

The American Diabetes Association recognizes PCOS as a risk factor for type 1 diabetes.

<p>False (B)</p> Signup and view all the answers

What does historical trauma refer to in the context of American Indian women?

<p>The long-term impact of colonization, cultural suppression, and historical oppression.</p> Signup and view all the answers

Polycystic ovary syndrome (PCOS) is a chronic, ______ disorder.

<p>androgen-excess</p> Signup and view all the answers

What were key informants in the study primarily interviewed about?

<p>PCOS symptoms that mattered most to them (B)</p> Signup and view all the answers

What is the main focus of Rebecca Carron's study?

<p>Baseline characteristics and effects of obesity in polycystic ovary syndrome.</p> Signup and view all the answers

Which publication discussed the criteria and prevalence of polycystic ovary syndrome?

<p>Fertility and Sterility (B)</p> Signup and view all the answers

Polycystic ovary syndrome is only a metabolic disorder.

<p>False (B)</p> Signup and view all the answers

What is one of the major health challenges mentioned for American Indian women?

<p>Insulin resistance and reproductive health issues.</p> Signup and view all the answers

Match the following studies or articles with their main topics:

<p>American Diabetes Association (2018) = Classification and diagnosis of diabetes Rotterdam ESHRE/ASRM = Diagnostic criteria related to polycystic ovary syndrome Haozous &amp; Neher (2015) = Best practices for clinical partnerships with Indigenous populations Tomlinson et al. (2017) = Diagnosis and lived experience of polycystic ovary syndrome</p> Signup and view all the answers

What is required for a PCOS diagnosis according to the Rotterdam criteria?

<p>All of the above (D)</p> Signup and view all the answers

Conditions that mimic PCOS such as thyroid disease need to be excluded for a PCOS diagnosis.

<p>True (A)</p> Signup and view all the answers

What are the six qualitative criteria used by the research team to substantiate data?

<p>Credibility, confirmability, meaning-in-context, recurrent patterning, saturation, and transferability</p> Signup and view all the answers

The average body mass index of the key informants was _____ kg/m2.

<p>37.68</p> Signup and view all the answers

How many key informants in the study were trying to become pregnant?

<p>6 (A)</p> Signup and view all the answers

What were the three universal themes identified in the study?

<p>Control of PCOS symptoms, culturally congruent PCOS education and health care, tribal culture and values influencing health care attitudes.</p> Signup and view all the answers

Match the following themes with their corresponding patterns:

<p>Theme 1: Control of PCOS symptoms = Patterns include frustration and loss of femininity Theme 2: Culturally congruent PCOS education = Patterns include lack of education and involvement in treatment options Theme 3: Tribal culture and values = Patterns include community awareness and traditional practices</p> Signup and view all the answers

All key informants felt satisfied with the health care services they received for PCOS.

<p>False (B)</p> Signup and view all the answers

One of the barriers for women with PCOS regarding social activities is irregular and _____ menses.

<p>unpredictable</p> Signup and view all the answers

What did key informants express frustration about regarding their diagnoses?

<p>Delay in receiving a diagnosis due to providers misinterpreting symptoms.</p> Signup and view all the answers

What were common self-management strategies for PCOS mentioned?

<p>Diet and exercise</p> Signup and view all the answers

What type of diet did a key informant refer to as beneficial for PCOS?

<p>Traditional low-fat diet (C)</p> Signup and view all the answers

All key informants believed that support groups for women with PCOS would be helpful.

<p>False (B)</p> Signup and view all the answers

What was a major issue mentioned by key informants related to weight management?

<p>Eliminating soft drinks</p> Signup and view all the answers

Which condition was mentioned as stigmatizing and affected by PCOS symptoms?

<p>All of the above (D)</p> Signup and view all the answers

What did key informants want increased awareness about?

<p>PCOS symptoms and treatment</p> Signup and view all the answers

Key informants expressed the need for more ______ care options for PCOS.

<p>tribal-specific</p> Signup and view all the answers

All key informants strongly adhered to traditional health beliefs.

<p>False (B)</p> Signup and view all the answers

What was one common tribal belief related to health conditions?

<p>If it’s happening to my body, it’s meant to be.</p> Signup and view all the answers

What substance did key informants struggle to eliminate from their diet?

<p>Soft drinks (C)</p> Signup and view all the answers

Historical _________ trauma can influence health attitudes.

<p>intergenerational</p> Signup and view all the answers

Flashcards

Grounded Theory

A qualitative research method used to develop a theory from the data collected from participants.

Qualitative Research

A type of research that explores a topic deeply and aims to understand the meaning or experience of something.

Multiple Births

The birth of more than one child at a time, such as twins or triplets.

Postpartum Period

The time after childbirth, usually the first year.

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Social Psychological Problem

A problem related to how mothers of twins interact socially, mentally, and emotionally.

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Releasing the Pause Button

The process mothers go through to resume their lives after childbirth with multiple babies.

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Draining Power

The overwhelming feeling of exhaustion and stress experienced by mothers of twins in the postpartum period.

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Pausing Own Life

A phase where mothers put their own lives on hold to focus on their babies.

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Striving to Reset

The phase in which mothers try to find a balance in their lives after the overwhelming early postnatal period.

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Resuming Own Life

The phase when mothers begin to integrate their pre-baby lives into their new lives with twins.

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Theoretical Sampling

Collecting and analyzing data to determine what further data to collect.

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Constant Comparative Method

A method used to analyze qualitative data by identifying patterns and relationships in the data.

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Substantive Coding

Focuses on the meanings and concepts in the research topic, grounded in the participants' words.

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Theoretical Coding

Linking codes together to form broader categories and create a deeper understanding of a concept.

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Participant Observation

A research method where the researcher is actively involved in the participants' setting to gather data.

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Unstructured Interview

An interview where the researcher asks open-ended questions to encourage detailed answers from participants.

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Striving to Reset

The third phase in the process of releasing the pause button, characterized by strategies mothers of twins use to regain their lives after the demands of having multiples

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Establishing a Routine

A crucial strategy used by mothers of twins to manage their multiple infant responsibilities

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Shifting Priorities

Adapting priorities to center the care of twins, rather than previous activities like household chores

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Marshaling Help

Seeking support from family, friends, and professionals to manage the challenges of twin care through the first year

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Problem Solving

Developing creative solutions to unique problems encountered while parenting twins, such as feeding or soothing both infants simultaneously

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Venturing Out

Gradually resuming personal life and outside activities by taking twins out of the home in the period after birth

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Draining Power

The first phase of mothering twins, characterized by overwhelming demands, lack of time, and emotional tension stemming from caring for two infants simultaneously

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Unrelenting Demands

Constant and intense demands of childcare that mothers of twins describe as taxing physical resources

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Vanishing Time

The experience of mothers of twins, where their time seems to disappear due to the constant demands of caregiving.

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Torn Between Two

The emotional strain mothers feel when they must divide their attention and care between two infants, leading to guilt and stress

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Pausing Own Life

The second phase of releasing the pause button, a response to draining power, in which mothers experience a blurring of days, confinement, and feeling of self-sacrifice.

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Blurring of Days

The feeling of lost distinction between days and nights, as the care of twins creates a monotonous cycle for mothers

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Confining

The feeling of isolation and limited social interaction resulting from the demands of twin care.

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Self-Surrender

Sacrificing personal needs in favor of twin care, often resulting in considerable personal sacrifice and alteration to lifestyle

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Mothers' Guilt with Twins

Mothers of twins sometimes feel guilty about having to divide their attention equally between their children.

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"Maternal Justice"

The desire for mothers of twins to give each child fair and equal attention.

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Vanishing Time

The feeling of losing control over time, and lack of time for oneself or partner.

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Time Commitment (Twins)

More time required for feeding, care, and support needed for twins, especially if premature or poor feeders.

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Blurring of Days

A consequence of raising twins, where daily routines become less defined and consistent.

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Self-Surrender

A consequence where mothers feel a loss of personal identity and needs in raising their twins.

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Confining (Raising Twins)

Restriction of social mobility and freedom for parents of twins.

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Establishing a Routine

A crucial strategy for mothers of twins offering some structure and predictability.

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Lowering Expectations (twins)

Accepting compromises to daily standards to maintain well-being and focus on raising the twins.

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Problem Solving in Multiple Births

A common strategy where mothers create solutions to deal with issues related to raising multiple infants.

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Marshall Help in Twins

Seeking and utilizing assistance from support groups, family, or friends, important to parents of twins.

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Support Groups (Twins)

Groups of parents of multiples that provide a supportive environment and share experiences related to parenting multiples.

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Postpartum Depression (Multiple Births)

Depression in the postpartum period of twin births, with rates often exceeding those for singletons.

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Nursing interventions (Twins)

Specific strategies developed to support parents of twins in specific phases, leading to improved and realistic guidance.

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3-Month Postpartum Timeframe

A crucial time period for implementing strategies and support, according to research on twins' needs.

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American Indian women with PCOS

American Indian women with polycystic ovary syndrome (PCOS) experience unique cultural influences on their health beliefs and practices.

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Polycystic Ovary Syndrome (PCOS)

A chronic androgen-excess disorder affecting 4-21% globally, unknown cause, potentially genetic and environmental.

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Cultural experiences

American Indian women's experiences with PCOS, influenced by their cultural values and beliefs and health care practices.

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Control of PCOS symptoms

Cultural importance of managing PCOS symptoms for well-being.

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Culturally congruent PCOS education

Importance of culturally appropriate education and healthcare for PCOS.

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Tribal culture influence

Tribal culture significantly affects health care beliefs, practices, and treatment preferences of American Indian women with PCOS.

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Ethnonursing study

Qualitative research method using Leininger's theory to understand cultural experiences of women living with PCOS.

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Key Informants

Women with PCOS who provided insight into their cultural experiences.

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Leininger's Theory

Framework for understanding culture care diversity and universality, emphasizing the importance of culturally appropriate care.

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Historical Trauma

Long-term impact of colonization, cultural suppression, and historical oppression on American Indians.

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Intergenerational Trauma

The secondary impact of trauma on succeeding generations.

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Institutional Betrayal Trauma

Trauma caused by historical injustices and mistreatment.

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Culturally Congruent Care

Care that respects and honors patients' cultural values and beliefs.

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Symptom Management PCOS

Lifestyle changes, medications (contraceptives, antiandrogens), and/or fertility treatments are used to manage PCOS symptoms.

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PCOS Prevalence in American Indians

PCOS prevalence and symptoms vary across ethnicities, creating a need for culturally tailored care.

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PCOS Diagnosis Criteria

Requires confirmation of two of three signs: hyperandrogenism, oligoovulation/anovulation, or polycystic ovaries (ultrasound).

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PCOS Symptoms

Hyperandrogenism, oligoovulation/anovulation, and polycystic ovaries.

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Study Themes

Organized data patterns identified by the research team, showing three universal themes.

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Leininger's Criteria

Six qualitative criteria (credibility, confirmability, meaning-in-context, recurrent patterning, saturation, and transferability) for substantiating research data.

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Data Saturation

Point in research where no new information is extracted from participants.

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Key Informant Demographics

Data describing the characteristics of participants in the study (age, BMI, tribal affiliation, relationships, pregnancy status, education, and residence).

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Cultural Well-being

The integration of cultural values and practices into PCOS management.

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Culturally Congruent PCOS Education

Providing information about PCOS tailored to tribal perspectives and values.

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Tribal Values

Cultural norms and beliefs influencing health attitudes and practices.

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Historical Trauma

Past events impacting well-being and potentially influence health.

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Semistructured Interview Guide

Predefined questions for gathering data about PCOS experiences, management, and challenges.

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Infertility

Inability to conceive a child.

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Loss of Femininity

Feelings of inadequacy or diminished womanly identity experienced by PCOS patients.

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Weight Management

Managing weight to address PCOS symptoms or maintain a healthy weight.

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Transferability

The degree to which study findings can be applied to other similar populations.

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PCOS Management Strategies

Methods, such as diet and exercise, used to manage Polycystic Ovary Syndrome (PCOS) without medication.

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Traditional Diet

A diet low in fat, typically incorporating foods like deer, elk, corn, and fruits.

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Weight Management Challenges

Difficulties experienced by individuals with PCOS in controlling weight.

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Soft Drink Avoidance

The need to reduce or eliminate sugary drinks due to their negative impact on weight and diabetes risk.

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Stigmatized PCOS Symptoms

Acne, hirsutism (facial hair), and alopecia, causing social stigma and impacting femininity.

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Reservation Healthcare Services

The health care services available on Native American reservations.

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Limited Treatment Options

The availability of only specific treatments, often including metformin and oral contraceptives, for PCOS on reservations.

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Community Awareness

Increasing understanding and knowledge of PCOS within the tribal community.

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Historical Trauma Impact

The influence of past trauma, like boarding schools and cultural disruption, on health beliefs and behaviours.

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Traditional Practices

The use of practices like burning cedar, prayer, and traditional diets, to support well-being.

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Infertility Concerns

The difficulty women with PCOS often face in conceiving and the desire to have more tribal children.

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Cultural Congruent Care

Health care practices that are consistent with the cultural values and beliefs of affected communities.

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Cultural Care Preservation

Maintaining and promoting culturally-relevant health practices to maintain well-being.

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Cultural Care Accommodation

Strategies for adapting existing practices to better manage the health issues.

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Cultural Care Repatterning

Developing new approaches or solutions that improve health management for the culture.

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Polycystic Ovary Syndrome (PCOS)

A common hormonal disorder affecting women, often characterized by irregular periods, excess androgens, and ovarian cysts.

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American Indian women with PCOS

American Indian women with PCOS experience health challenges influenced by their tribal culture.

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Cultural experiences (PCOS)

PCOS experiences that are shaped by cultural values and beliefs, among American Indian women.

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Control of PCOS symptoms

Managing PCOS symptoms through lifestyle changes and treatments.

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Ethnonursing study

A research method that uses Leininger's theory to understand and address cultural experiences of individuals with PCOS.

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Leininger's Theory

A nursing theory emphasizing cultural diversity and care.

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Historical Trauma

The long-term impacts of past injustices/oppressions/trauma.

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Intergenerational Trauma

Trauma passed down through generations, affecting American Indians.

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Institutional Betrayal Trauma

Trauma resulting from government or institutional mistreatment.

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Culturally Congruent Care

Care that respects and responds to the cultural values and beliefs of a particular group.

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Symptom Management PCOS

Methods used to manage PCOS symptoms.

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PCOS Prevalence in American Indians

The occurrence of PCOS in American Indian populations, potentially varying from other groups.

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Tribal Culture Influence

Impact of tribal customs on health care beliefs/practices of American Indian women with PCOS.

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Study Notes

Releasing the Pause Button: Mothering Twins During the First Year of Life

  • Problem: Mothers of twins experience a "life on hold" feeling during the first year postpartum.
  • Process: Mothers use a four-stage process to "release the pause button:" (a) draining power, (b) pausing own life, (c) striving to reset, and (d) resuming own life.
  • Vulnerable Period: Initial 3 months postpartum is the most vulnerable for twin mothers.
  • Multiple Births Increase: Twin births have increased by 33% and triplet-plus births by 178% since the 1970s. In vitro fertilization contributes to this.
  • Nursing Challenges: Optimal care for high-risk multiple-birth families requires nurses to understand the unique problems and needs of these families.

Review of the Literature

  • Qualitative Studies: Most studies focused on mothers of multiples were from outside the US, in France, Great Britain, Italy, Israel, Taiwan.
  • Issues: Ambivalence, dealing with unusual demands, and difficulty relating to multiple children.
  • Solutions: Practical time and energy saving measures, treatment of children equally, establishing egalitarian relationships, and developing standardized child care routines.
  • Problems Identified in Taiwan: Inadequate sleep (49%), lack of time for other children (43%), mood fluctuations (39%), marital relationship problems (22%), and financial strain (18%).
  • Focus on Specific Social Psychological Problems: Research on social psychological problems particular to twin mothers and the processes they use to resolve them.
  • US Studies: A survey of 104 mothers of twins found issues with daily household tasks (40+% experiencing difficulty) and sleep (64%).
  • Cross-cultural Concerns: Stress and depression can impact >25% of multiple-birth parents prenatally and postnatally. Factors include premature deliveries, sleep deprivation, social isolation, and constant demands.

Method

  • Research Questions: Investigate the specific basic social psychological problem mothers of twins encounter during the first year after delivery, and the social-psychological process they use to address it.
  • Research Design: Grounded theory, using symbolic interactionism as a framework.
  • Participants: 16 married mothers of twins, ranging from 24 to 43 years, attending Parents of Multiples Group meetings; varying ethnicity and parity.
  • Data Collection: Combination of participant observation (at meetings and in the homes) and semi-structured interviews.
  • Data Analysis: Constant comparative method using substantive and theoretical coding.

Results

  • Problem: Life on hold.
  • Process: Releasing the pause button (four phases): (a) Draining power, (b) pausing life, (c) striving to reset, (d) resuming life.
  • Strategies in Striving to Reset: Establishing a routine, shifting priorities, marshaling help, and problem solving.
  • Phase 1 (Draining Power): Mothers describe overwhelming demands, vanishing time, and feeling torn between the two babies.
  • Phase 2 (Pausing Own Life): Mothers experience a blurring of days, feeling confined, and a sense of self-surrender.
  • Phase 3 (Striving to Reset): Mothers adopt strategies such as establishing routines, seeking help, prioritizing tasks, and learning to solve problems creatively.
  • Phase 4 (Resuming Own Life): Mothers regain a sense of manageability and reap the blessings of mothering their twins as they get older.

Discussion

  • Comparison with Previous Research: Research confirms the challenges of mothering multiples.
  • Theoretical Contribution: A comprehensive understanding of the process mothers utilize to adjust to the challenging dual parenting dynamic.
  • Implications: The research highlights the need for support and interventions, particularly in the most vulnerable period.

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Related Documents

Mothering Twins During First Year - 2002 PDF
Qualitative Article: Cultural Experiences of American Indian Women With PCOS - PDF

Description

Explore the unique challenges and experiences mothers face during the first year of life with twins. This quiz covers the four-stage process of adapting to life with multiples and insights from qualitative studies. Discover how nursing challenges and increased twin births impact maternal experiences.

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